Eight judgments that shaped the #Euthanasia debate in India

Aruna Shanbaug, a former nurse at Mumbai’s KEM Hospital passed away this morning after spending more than 40 years in a permanent vegetative state. Shanbaug suffered brain damage as a result of being brutally raped by a hospital sweeper in 1973..In 2009, journalist Pinky Virani approached the Supreme Court, seeking permission to lawfully put Shanbaug off life support..The incident sparked a widespread debate on the merits of legalizing euthanasia in India. While the Supreme Court did not allow Shanbaug to be euthanized, it did however, hold that passive euthanasia is allowed, under certain circumstances..Here are eight judgments that have helped construct the Indian jurisprudence on the topic of euthanasia..Maruti Shripati Dubal vs State Of Maharashtra – Bombay HC (1986).Facts: The petitioner, a police constable, met with a road accident in 1981 and sustained head injuries. He developed schizophrenia and other mental ailments as a result. In 1985, he attempted to commit suicide by self-immolation. An offence under s. 309 IPC (attempt to commit suicide) was registered against him..Judgment: Section 309 of IPC held to be ultra vires Article 21, although subsequently overruled by the Supreme Court..Reasoning: “Fundamental rights have their positive as well as negative aspects. For example, the freedom of speech and expression includes freedom of speech and expression includes freedom not to speak and to remain silent…logically it must follow that right to live as recognised by Art. 21 will include also a right not to live or not to be forced to live.”.Airedale NHS Trust v. Bland (1993).This is a British case that finds mention in a number of Indian cases on euthanasia..Facts: A young football fan was caught in the Hillsborough stampede, which reduced him to a persistent vegetative state. The hospital, with the consent of his parents, applied for a declaration that it might lawfully discontinue all life support..Judgment: The declaration was granted..Reasoning: Withdrawal of treatment was, however, properly to be characterized as an omission. An omission to act would nonetheless be culpable if there was a duty to act. There was no duty to treat if treatment was not in the best interests of the patient. Since there was no prospect of the treatment improving his condition the treatment was futile and there was no interest for the patient in continuing the process of artificially feeding him upon which the prolongation of his life depends..P.Rathinam v. Union of India – Supreme Court (1994).Facts: Two petitions were filed in the apex court contending Section 309 of IPC to be violative of Articles 14 and 21 of the Constitution..Judgment: Right to life includes right to die..Reasoning: “Though what we propose to decide in these cases would, therefore, relate to the offence of attempted suicide, it is nonetheless required to be stated that euthanasia is not much unrelated to the act of committing suicide inasmuch as wherever passive euthanasia has been held to be permissible under the law, one of the requirements insisted upon is consent of the patient or of his relations in case the patient be not in a position to give voluntary consent.”.Gian Kaur v. State of Punjab – Supreme Court (1996).Facts: The appellant and her brother were convicted by a trial court for abetment of suicide. The constitutional validity of section 306 of IPC was challenged in the Supreme Court..Judgment: P. Rathinam judgement overruled. Right to die is not part of Article 21..Reasoning: “The significant aspect of ‘sanctity of life’ is also not to be overlooked. Article 21 is a provision guaranteeing protection of life and personal liberty and by no stretch of imagination can extinction of life’ be read to be included in protection of life’. Whatever may be the philosophy of permitting a person to extinguish his life by committing suicide, we find it difficult to construe Article 21 to include within it the right to die’ as a part of the fundamental right guaranteed therein.”.C.A. Thomas Master v. Union of India – Kerala HC (2000).Facts: The petitioner, an 80-year-old man, did not want to commit suicide, but wanted to voluntarily put an end to his life or donate his bodily organs to facilitate voluntary death..Judgment: Writ dismissed..Reasoning: “…main emphasis was on the distinction between suicide commonly understood, and the right to voluntarily terminate one’s life. According to him, the Apex Court has not considered this distinction while laying down the law in Gian Kaur’s case… The possibility of misuse, or abuse, of such a right and exploitation on that count, cannot be ruled out. In the absence of any legislation in that behalf, and having regard to the discussion in Gian Kaur’s case, no distinction can be made between suicide as ordinarily understood, and the right to voluntarily put to an end to one’s life.”.Aruna Ramchandra Shanbaug v. Union of India – Supreme Court (2011).Facts: Pinky Virani, an activist had filed a petition in the Supreme Court to put Shanbaug’s suffering to an end by taking her off life support..Judgment: Considering Shanbaug’s state and the care she was being given by the hospital staff, the apex court dismissed the writ. However, the Bench, presided by Justice Katju held that passive euthanasia was lawful under these conditions:.when a person is only kept alive mechanically, i.e. when not only consciousness is lost, but the person is only able to sustain involuntary functioning through advanced medical technology–such as the use of heart-lung machines, medical ventilators etc.when there is no plausible possibility of the person ever being able to come out of this stage. Medical “miracles” are not unknown, but if a person has been at a stage where his life is only sustained through medical technology, and there has been no significant alteration in the person’s condition for a long period of time–at least a few years–then there can be a fair case made out for passive euthanasia..Reasoning: “A decision has to be taken to discontinue life support either by the parents or the spouse or other close relatives, or in the absence of any of them, such a decision can be taken even by a person or a body of persons acting as a next friend…Hence it is for the KEM hospital staff to take that decision. The KEM hospital staff have clearly expressed their wish that Aruna Shanbaug should be allowed to live.”.H B Karibasamma v. Union of India – Karnataka HC (2012).Facts: The petitioner was a 70-year-old-woman who had a condition called ‘Inter-vertebral Disc Prolapse’ which is commonly known as ‘Slip Disc’. She was not only suffering from physically excruciating pain but was also disadvantaged economically..Judgment: Petitioner cannot be termed as a person who is terminally ill or is in a permanent vegetative state, inasmuch as she does not require administration of euthanasia..Reasoning: “…even if a decision is taken by the near relatives or doctors or next friend to withdraw life support, such a decision requires approval from the High Court concerned as laid down in Airedale’s case. In our opinion, this is even more necessary in our country as we cannot rule out the possibility of mischief being done by relatives or others for inheriting the property of the patient.”.Common Cause (A Regd. Society) v. Union of India – Supreme Court (2014).Facts: Petitioner had emphasized the need for a law to be passed which would authorize the execution of “a Living Will” in the event of their going into a state when it will not be possible for them to express their wishes..Judgment: “In succinct, the Constitution Bench [in Gian Kaur’s case] did not express any binding view on the subject of euthanasia, rather reiterated that legislature would be the appropriate authority to bring the change…Accordingly, we refer this matter to a Constitution Bench of this Court for an authoritative opinion.”